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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2018; 10(9): 175-183
Published online Sep 16, 2018. doi: 10.4253/wjge.v10.i9.175
Proposed approach to the challenging management of progressive gastroesophageal reflux disease
Joachim Labenz, Parakrama T Chandrasoma, Laura J Knapp, Tom R DeMeester
Joachim Labenz, Internal Medicine, Diakonie Klinikum, Jung-Stilling Hospital, Siegen 57074, Germany
Parakrama T Chandrasoma, Tom R DeMeester, Keck School of Medicine, University of Southern California, Los Angeles, CA 91108, United States
Laura J Knapp, PharmaGenesis London, London SW1A 2DD, United Kingdom
Author contributions: Labenz J, Chandrasoma PT, Knapp LJ and DeMeester TR designed the research, performed the research and wrote the paper.
Conflict-of-interest statement: Joachim Labenz has served as a consultant to EndoStim and Reckitt Benckiser, and has received honoraria for scientific presentations from AstraZeneca, EndoStim, Reckitt Benckiser, and Torax Medical Inc. Parakrama Chandrasoma has no conflict of interest. Laura Knapp is an employee of PharmaGenesis London, which received funding from EndoStim. Tom R DeMeester is currently a consultant to Torax Medical Inc. and has received honoraria for consultation and scientific presentation from EndoStim.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Joachim Labenz, MD, Doctor, Professor, Internal Medicine Diakonie Klinikum, Jung-Stilling Hospital, 40 Wichernstraße, Siegen 57074, Germany. joachim.labenz@diakonie-sw.de
Telephone: +49-27-13334243 Fax: +49-27-13334242
Received: March 17, 2018
Peer-review started: March 17, 2018
First decision: April 11, 2018
Revised: May 22, 2018
Accepted: June 13, 2018
Article in press: June 13, 2018
Published online: September 16, 2018
Core Tip

Core tip: A review of the literature on gastroesophageal reflux disease (GERD) progression and the associated physiological and pathological changes was performed. Current evidence shows that GERD can progress; however, patients at risk of progression may not be identified early enough for it to be prevented. We propose that endoscopically normal patients who partially respond or do not respond to PPI therapy undergo routine biopsies at the squamocolumnar junction to identify histological changes that may predict future progression. This will allow earlier intervention, aimed at preventing Barrett’s esophagus.